ETERNA VEIN & MEDICAL AESTHETICS, PLLC (NPI# 1366785685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366785685 |
| Entity Type | Organization |
| Organization Name | ETERNA VEIN & MEDICAL AESTHETICS, PLLC |
| Practice Address |
1803 S Meridian Puyallup WA 98371-7513 |
| Practice Telephone | 2532683400 |
| Mailing Telephone | 2532683400 |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2013-06-13 |
| Authorized Official Name | DR. ROBERT W OSBORNE JR. (OWNER) |
| Authorized Official Telephone | 2532683400 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
603211178 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
1803 S MERIDIAN |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98371-7513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053403634 | Mark S. Kim | Family Medicine | 1803 S Meridian, Puyallup, WA 98371 | 2006-09-29 |
| 1922510726 | Jessica Armitage | Nurse Practitioner | 1803 S Meridian, Puyallup, WA 98371-7513 | 2017-11-02 |
| 1295966471 | Sara Anne Mohagen | Physical Therapist | 1803 S Meridian, Suite A, Puyallup, WA 98371-7513 | 2009-08-05 |
| 1669492286 | Robert W Osborne Jr. | Surgery | 1803 S Meridian, Puyallup, WA 98371-7513 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588141550 | Karen Lynn Sorensen | Massage Therapist | 922 Valley Ave Nw Suite 101, Puyallup, WA 98371 | 2018-07-23 |
| 1487140257 | Bradley Dupea | Specialist/Technologist | 5702 44th St Se, Puyallup, WA 98371 | 2018-07-05 |
| 1740778695 | Pedraum Heydari | Dentist | 109 N Meridian Suite A, Puyallup, WA 98371 | 2018-04-26 |
| 1487030359 | Jennifer Block | Dental Hygienist | 601 4th Ave Sw, Puyallup, WA 98371 | 2015-08-03 |
| 1023423431 | On Your Own Inc. | Registered Nurse | 1602 Peach Park Ln Nw, Puyallup, WA 98371 | 2014-06-24 |
| 1841614997 | Enrique Somera | Registered Nurse | 1107 29th St Nw, Puyallup, WA 98371 | 2014-02-10 |
| 1033540893 | Ching Ju Chuang | Dentist | 1002 N. Meridian, Suite 104a, Puyallup, WA 98371 | 2013-12-04 |
| 1104161876 | Denise L. Vanaman | Registered Nurse | 214 W. Main, Puyallup, WA 98371 | 2012-12-06 |
| 1336491018 | Tacoma School District | Physical Therapy Assistant | 1721 8th Ave. S.w., Puyallup, WA 98371 | 2012-10-05 |
| 1275882052 | Robert Francis Saxton | Health Educator | 1121 W. Stewart, Puyallup, WA 98371 | 2012-09-07 |
| Find all providers in zip 98371 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669492286 | Robert W Osborne Jr. | Surgery | 1803 S Meridian, Puyallup, WA 98371-7513 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710496922 | Sunnyside Community Hospital Association | Surgery | 1005 W Walnut St Ste 201, Yakima, WA 98902-3384 | 2017-09-20 |
| 1750762415 | Anna Ohlsson | Surgery | 325 9th Ave # 359908, Seattle, WA 98104-2420 | 2015-06-17 |
| 1356722938 | Usa Vascular Centers of Kent Pllc | Surgery | 26124a Pacific Hwy S Ste A, Kent, WA 98032-6910 | 2015-06-09 |
| 1154602084 | Memorial Physicians, Pllc | Surgery | 1812 E Edison Ave, Sunnyside, WA 98944-1653 | 2011-09-06 |
| 1528387941 | Sara Jane Wasilenko | Surgery | 128 Lilly Rd Ne Ste 205, Olympia, WA 98506-7400 | 2010-05-25 |
| 1801051404 | Franciscan Medical Group | Surgery | 710 S 348th St, Ste A, Federal Way, WA 98003-7042 | 2008-07-23 |
| 1013104165 | John S Arthur | Surgery | 2528 Wheaton Way Ste 101, Bremerton, WA 98310-3305 | 2007-10-02 |
| 1891986097 | Vascular Associates, Ps | Surgery | 801 Broadway Ste 522, Seattle, WA 98122-4325 | 2007-08-05 |
| 1447464730 | Mai Thanh Pham | Surgery | 1229 Madison St Suite # 1190, Seattle, WA 98104 | 2007-05-09 |
| 1649491481 | Dae Young Lee | Surgery | 1100 Goethals Drive 3rd Floor, Kadlec Clinic Vascular Surgery, Richland, WA 99352-3304 | 2007-05-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.